Managing Suture Dehiscence After Fistula Excision Surgery

Dehiscence of the suture line after fistula excision surgery?

Hello Dr.
Chang,
Today is the third day post-fistula excision surgery.
While caring for the wound, I noticed that the original sutures have come undone.
Should any action be taken? There is no significant bleeding from the wound, only some blood when wiping after using the restroom.
Thank you for your response, Dr.
Chang.

Mr. Huang, 40~49 year old female. Ask Date: 2022/09/18

Dr. Zhang Shuhao reply Surgery

The fistula surgery uses absorbable sutures, which will mostly start to fall out in about a week.
However, if they fall out earlier, it is not a concern.
As long as there is no bleeding, you can continue with the usual care, including taking warm sitz baths and changing the ointment as needed.
Please return for your scheduled follow-up appointment to check the wound.

Reply Date: 2022/09/18

More Info

Managing suture dehiscence after a fistula excision surgery can be a concerning issue, especially when it occurs just a few days post-operation. Suture dehiscence refers to the separation of the surgical incision, which can happen due to various reasons, including infection, tension on the wound, or inadequate healing. In your case, since you noticed the dehiscence three days after the surgery, it is essential to take appropriate steps to manage the situation effectively.

First and foremost, it is crucial to keep the area clean. Gently cleanse the wound with mild soap and water, avoiding any harsh scrubbing that could further irritate the area. After cleaning, pat the wound dry with a clean towel. If there is any discharge or blood, it is advisable to use sterile gauze to absorb it, but avoid applying excessive pressure that could exacerbate the dehiscence.

Since you mentioned that there is no significant bleeding, this is a positive sign. However, the presence of blood during wiping after using the restroom indicates that there may still be some irritation or minor bleeding from the wound. It is essential to monitor the amount of blood; if it increases or if you notice any signs of infection (such as increased redness, swelling, warmth, or pus), you should seek medical attention promptly.

In terms of further management, it is advisable to contact your surgeon or healthcare provider as soon as possible. They may recommend a follow-up appointment to assess the wound and determine if any additional treatment is necessary. Depending on the extent of the dehiscence, your doctor may decide to re-suture the wound or apply a different dressing to promote healing. In some cases, they might suggest a wound care regimen that includes the use of topical antibiotics to prevent infection.

Additionally, it is essential to avoid any activities that could put strain on the wound, such as heavy lifting or vigorous exercise, until you receive further guidance from your healthcare provider. Resting and allowing your body to heal is crucial during this time.

In summary, managing suture dehiscence after fistula excision surgery involves keeping the wound clean, monitoring for signs of infection, and consulting with your healthcare provider for further evaluation and treatment. It is vital to follow their recommendations closely to ensure proper healing and minimize the risk of complications. Remember, timely intervention can significantly improve outcomes and facilitate a smoother recovery process.

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